Physical Activity Exposure Research Articles

The association of knee bending and physical activity with incident pain and functional limitation over 4 years in knee osteoarthritis

Purpose: Engaging in knee bending activities, e.g. climbing stairs, kneeling, or squatting, is a risk factor for the incidence and progression of knee OA and may be deleterious for knee pain. However, engaging in some knee bending activities is, in general, beneficial for lower extremity strength, which is related to future functional outcomes. Similar benefits to physical function are observed with physical activity (PA), e.g. walking. Knee bending activities and PA can co-occur, yet little is known about the joint association of knee bending and PA with pain and functional limitation. Therefore, the purpose of this study was to investigate the joint association of knee bending and objectively-measured PA with incident pain and functional limitation in adults with or at risk for knee OA. Methods: We used data from the 48-month and 96-month visits of the Osteoarthritis Initiative (OAI), a large cohort study of adults with or at risk for knee OA. Knee bending activities and objectively-measured PA (steps/day) exposures were collected at the 48-month visit (baseline). Knee bending was measured using four Yes/No questions used to determine study eligibility: climbing up a total of 10 or more flights of stairs, kneeling 30 minutes or more, squatting 30 minutes or more, and lifting or moving objects weighing 25 pounds or more by hand. Positive responses were summed and categorized as Low Bending (0-1 Yes responses) and High Bending (2-4 Yes responses). PA was measured with an Actigraph GT1M accelerometer and was separately dichotomized into Steps Active and Steps Inactive using 6000 steps/day, based on previous studies showing this is a meaningful threshold for preventing functional limitation. To investigate the joint association of knee bending and PA, we created a four-level exposure variable: (1) Steps Inactive & Low Bending, (2) Steps Active & Low Bending, (3) Steps Inactive & High Bending, (4) Steps Active & High Bending. Incident pain and functional limitation outcomes were assessed at the 96-month visit. VAS Pain (0-10) was dichotomized using patient acceptable symptom state levels, with a score of 3/10 as the cutoff for meaningful pain. Functional limitation was defined using slow gait speed from a 20-meter walk test (<1.22 m/s) which represents the inability to safely cross a timed street intersection. To determine the association of our four-level knee bending and PA exposure with incident pain and functional limitation, we used binary logistic regression to calculate risk ratios (RR) and 95% confidence intervals (95% CI), adjusting for potential confounders at baseline. Results: Of the adults with knee bending and valid accelerometry data who were free of meaningful pain (n = 1268) and functional limitation (n = 1307) at the 48-month visit, 1115 (age: 62.9 ± 8.4 years old, sex: 50.5% female, BMI: 28.0 ± 4.5 kg/m2) had all outcomes at the 96-month visit. Of those, 393 adults reported 0 or 1 knee bending activities and 722 adults reported 2 to 4 knee bending activities. 826 adults reported engaging in at least 1 knee bending activity on at least 2-3 days of the week. Steps Active & High Bending had 23% reduced risk for incident slow gait speed compared with Inactive & Low Bending, which met statistical significance (Adjusted RR [95% CI]: 0.77 [0.68 - 0.88]). Similarly sized protective effects that met statistical significance were found for the Steps Active & Low Bending and the Steps Inactive & High Bending groups with slow gait speed (Table 1B). There was no significant association between any of the exposure groups with incident pain above a patient acceptable symptom state (Table 1A). Conclusions: Adults who were active or engaged in 2 or more knee bending activities were at reduced risk for functional limitation 4 years later, with the greatest risk reduction seen in the Steps Active & High Bending group. We did not find knee bending activities and/or PA to be associated with incident knee pain above a patient acceptable symptom state. Despite the relationship between knee bending and progression of knee OA, these findings suggest that engaging in more knee bending activities, regardless of PA level, is not adversely related to pain or physical function.

Characteristics and associated factors of physical activity-related injuries among university students in southern China

This cross-sectional study aimed to describe the characteristics of physical activity-related injury (PARI) and to explore its associated factors among university students in Chaoshan district. Selected from the baseline survey in March and April, 434 students graded 1–3 from two universities were interviewed face-to-face in April and May 2017. Socio-demographics, physical activity (PA) participation, risk-taking behaviors, and PARI occurrences in the past 12 months were collected. Group Lasso logistic regression was applied to identify the risk factors of PARI. Totally, 317 PARI episodes were reported by 184 subjects with an overall injury risk of 0.73 injuries/student/year (males: 1.00, females: 0.63) and an injury incidence density of 0.81 injuries per 1000 PA exposure hours (males: 1.13, females: 0.69). Most injuries involved the lower extremities and were sprains and strains. Males, sports team members, and those with high-risk rebellious and anti-social behaviors were more likely to sustain PARI compared to their counterparts. Those who participated in vigorous-intensity PA with longer duration (particularly ≥ 150 min/week) were at a higher risk for PARI. This study indicates that PARI is a health concern among university students and great efforts should be taken to prevent them from PARI when promoting a physically active lifestyle.

Associations of accelerometer-measured physical activity and physical activity-related cancer incidence in older women: results from the WHI OPACH Study

BackgroundWe examined the associations between accelerometry-measured physical activity (PA) and incidence of 13 cancers among a cohort of postmenopausal women.MethodsIn this prospective study, 6382 women wore ActiGraph GT3X+ accelerometers at the hip for up to 7 days during 2012–2013, and were followed over a median of 4.7 years for diagnosis of 13 invasive cancers. Calibrated intensity cut points were used to define minutes per day of total, light and moderate-to-vigorous PA. We used multivariable Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for tertiles, and one-standard deviation (SD) unit increments of PA exposures in relation to cancer incidence. We examined effect measure modification by age, race/ethnicity, body mass index and smoking history.ResultsThe highest (vs. lowest) tertiles of total, light and moderate-to-vigorous PA were associated with covariate-adjusted HRs of 0.72 (95% CI = 0.53–0.97), 0.81 (95% CI = 0.60–1.09) and 0.66 (95% CI = 0.48–0.91), respectively. In age-stratified analyses, HRs for total PA were lower among women <80 years (HRper one-SD = 0.75, 95% CI = 0.63–0.90) than among women ≥80 years (HRper one-SD = 0.99, 95% CI = 0.82–1.18) (PInteraction = 0.03). Race/ethnicity, BMI and smoking did not strongly modify these associations.ConclusionsEngaging in physical activity may play a beneficial role in the prevention of certain cancers in older women.

Accelerometer-measured Physical Activity and Breast Cancer Incidence in the WHI OPACH Study

Abstract To examine the associations between accelerometer-measured physical activity (PA) and breast cancer incidence among a cohort of postmenopausal women. Methods: This longitudinal study included 6,382 women (mean age 79 ± 6 years; 49.4% non-Hispanic white, 33.7% non-Hispanic Black, 16.9% Hispanic) without a history of breast cancer who participated in the Women's Health Initiative (WHI) Objective Physical Activity and Cardiovascular Health (OPACH) Study. During 2012–2013, participants wore an ActiGraph GT3X+ accelerometer at the hip for up to 7 days. Accelerometer intensity counts were specially calibrated to PA in older women. The resulting data were used to compute minutes per day spent in total PA, light intensity PA (e.g., usual walking), and moderate-to-vigorous PA (MVPA; e.g., brisk walking). Physician-adjudicated first diagnosis of in situ (n = 18) or invasive (n = 103) breast cancer was ascertained over a median follow-up of 5.6 years. We used multivariable Cox regression to estimate covariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for tertiles and one-standard deviation (SD) unit increments of PA exposures in association with breast cancer incidence. We examined effect measure modification by age, race/ethnicity, body mass index (BMI), and smoking history. Results: The highest (vs. lowest) tertile of total PA was associated with a breast cancer incidence HR of 0.67 (95% CI = 0.43–1.05) and this association was more pronounced for MVPA (HR = 0.61, 95% CI = 0.38–1.00) than for light PA (HR = 0.81, 95% CI = 0.53–1.26). In BMI-stratified analyses, HRs for total (PInteraction = 0.04) and light PA (PInteraction = 0.01), but not MVPA (PInteraction = 0.79), were stronger among women with BMI ≥ 30 kg/m2 (n cancer events = 48; total PA HRper one-SD = 0.69, 95% CI = 0.50–0.96; light PA HR = 0.69, 95% CI = 0.50–0.95) than among women with BMI &amp;lt; 30 kg/m2 (n cancer events = 73; total PA HRper one-SD = 1.07, 95% CI = 0.84–1.38; light PA HR = 1.13, 95% CI = 0.89–1.44). Age, race/ethnicity, and cigarette smoking history did not strongly modify these associations (PInteraction's ≥ 0.16). Conclusions: Engaging in high levels of PA may play a beneficial role in the prevention of breast cancer in older women, and in particular among postmenopausal women with BMI ≥ 30 kg/m2.

Vascular effects of physical activity are not modified by short-term inhaled diesel exhaust: Results of a controlled human exposure study

BackgroundThe combined effects of physical activity and air pollution exposure on vascular function are insufficiently understood, particularly after the inhalation of a β2-agonist, a vasodilating agent. ObjectiveTo assess the micro- and macrovascular response to physical activity after β2-agonist use while breathing diesel exhaust (DE) in individuals with exercise-induced bronchoconstriction. MethodsOn four exposure visits, eighteen adults inhaled either 400 μg of the β2-agonist salbutamol or placebo before resting for 60 min, followed by a 30-min cycling bout. During rest and cycling, participants inhaled filtered air (FA) or DE (300 μg/m3 of PM2.5). Microvascular (central retinal arteriolar and venular equivalents, CRAE and CRVE, respectively) and macrovascular parameters (blood pressure (BP)) and heart rate (HR)) were assessed at baseline (T1), 10 min (T2) and 70 min (T3) after cycling. ResultsThe cycling bout increased CRAE (T2-T1 difference (95th % confidence interval): 4.88 μm (4.73, 5.00 μm), p < 0.001; T3-T1 difference: 2.10 μm (1.62, 2.58 μm), p = 0.031) and CRVE (T2-T1 difference: 3.78 μm (3.63, 3.92 μm), p < 0.001; T3-T1 difference: 3.73 μm (3.63, 3.92 μm), p < 0.001). The exposure to DE had no effect on CRAE (FA-DE difference at T2: 0.46 μm (−0.02, 0.92 μm); p = 0.790; FA-DE difference at T3: 1.76 μm (1.36, 2.16 μm), p = 0.213) and CRVE (FA-DE difference at T2: 0.26 μm (−0.35, 0.88 μm), p = 0.906; FA-DE difference at T3: 0.55 μm (0.05, 1.06 μm), p = 0.750). Compared to T1, systolic BP was decreased at T2 by 2.5 mmHg (2.8, 2.3 mmHg, p = 0.047), independent of inhaled exposure. Heart rate at T2 was significantly increased by 3 bpm (2, 3 bpm, p = 0.025) after the DE-exposure when compared to FA. DiscussionAcute physical activity induces a vasodilatory response in the micro- and macrovasculature in healthy adults by increasing CRAE and CRVE, and by reducing systolic BP post exercise, despite breathing DE. The DE-associated increase in HR might be indicative of an increased sympathetic response to physical activity while breathing DE.

Brain health INnovation Diplomacy: a model binding diverse disciplines to manage the promise and perils of technological innovation.

Brain health diplomacy aims to influence the global policy environment for brain health (i.e. dementia, depression, and other mind/brain disorders) and bridges the disciplines of global brain health, international affairs, management, law, and economics. Determinants of brain health include educational attainment, diet, access to health care, physical activity, social support, and environmental exposures, as well as chronic brain disorders and treatment. Global challenges associated with these determinants include large-scale conflicts and consequent mass migration, chemical contaminants, air quality, socioeconomic status, climate change, and global population aging. Given the rapidly advancing technological innovations impacting brain health, it is paramount to optimize the benefits and mitigate the drawbacks of such technologies. We propose a working model of Brain health INnovation Diplomacy (BIND). We prepared a selective review using literature searches of studies pertaining to brain health technological innovation and diplomacy. BIND aims to improve global brain health outcomes by leveraging technological innovation, entrepreneurship, and innovation diplomacy. It acknowledges the key role that technology, entrepreneurship, and digitization play and will increasingly play in the future of brain health for individuals and societies alike. It strengthens the positive role of novel solutions, recognizes and works to manage both real and potential risks of digital platforms. It is recognition of the political, ethical, cultural, and economic influences that brain health technological innovation and entrepreneurship can have. By creating a framework for BIND, we can use this to ensure a systematic model for the use of technology to optimize brain health.

Postpartum Physical Activity and Weight Retention within One Year: A Prospective Cohort Study in Vietnam.

After delivery, mothers are encouraged to increase physical activity (PA) gradually to regulate body weight; however, data on PA in relation to postpartum weight retention remains scarce, particularly among Asian women. In a cohort of 1617 Vietnamese mothers, we investigated the prospective association between habitual PA exposures at 3-month postpartum and weight retention at 6-month and 12-month postpartum. Detailed information on PA intensity and domains was collected from participants using a validated instrument specifically for Vietnamese women. Linear regression analyses and a general linear model for the repeated weight retention measures were used to ascertain the apparent relationships. On average, the participants reported 3.6 (SD 3.9) and 2.6 (SD 3.8) kg weight loss at 6- and 12-month postpartum, respectively. Total and light-intensity PA were inversely associated with the postpartum weight retention (p for trend <0.05). Our findings highlight the importance of resuming PA in the early postpartum period as an appropriate weight management strategy.

Abstract 126: The Influence of Physical Activity on Cavernous Malformation Hemorrhage

Background: Cavernous malformations (CM) are low flow vascular malformations of the central nervous system. Brainstem location and prior hemorrhage increase the risk for future hemorrhage. Little is known about the influence of physical activity on increasing the risk of hemorrhage. Methods: Consecutive patients with radiologically confirmed CM were recruited to participate in a prospective registry beginning in 2015. A structured interview, survey, and examination were performed at baseline. Patients were asked if anything unusual occurred in the days leading to initial clinical presentation. Medical records and magnetic resonance imaging (MRI) studies were reviewed. Patients were surveyed about their involvement in select physical activity after the diagnosis of CM was made. Follow up surveys were sent annually to patients to ascertain new clinical hemorrhages. Follow up was censored at last follow up, hemorrhage, surgery, or death. Univariate analysis was performed to assess whether involvement in select physical activities increased the risk of prospective hemorrhage. Results: Of 195 patients, 117 (60 %) were female and the average age at diagnosis was 41 years (31-56 years). One hundred and three (52.8%) patients returned the survey about physical activity after diagnosis (cerebral n=100; spine n=3). Twenty-three patients had a prospective hemorrhage over 539.4 patient years. Five of these patients were removed from the analysis because they had less than 6 weeks of physical activity exposure before censor. Of 98 remaining patients, there was no difference in prospective hemorrhage risk in those patients participating 3 or more times monthly in walking, running, lifting more than 20 pound weights, lifting less than 20 pound weights, or participating in non-contact sports. Very few patients reported participation in contact sports (n=5), scuba diving (n=2) or high altitude climbing (n=1) more than 3 times monthly. Conclusion: Aerobic activity and non-contact sports do not increase the risk of hemorrhage in patients with cerebral CM and patients should not be restricted. Less information is known about contact sports, high altitude climbing or scuba diving and those with spinal cord CM.

Life 2.0: A Comprehensive Cross-Sectional Profiling of the ‘New Normal’ in 244 Long-Term Allogeneic Hematopoietic Cell Transplantation Survivors Compared to the General Population

We performed a cross-sectional study to describe the survivorship profile of a convenience sample of 244 allogeneic hematopoietic cell transplantation (HCT) recipients based on a comprehensive health status model and we compared them to controls from the general Belgian population using the Health Interview Survey database (matched 1:3 based on age, gender and province of residence), a national assessment performed every five years since 1997 to evaluate the general health status of the population. Included patients were above age 18, at least 2 years post-HCT and presented to our center for a scheduled outpatient appointment. Patients hospitalized for a life-threatening condition, presenting with any other major illness (resulting in an expected survival of less than 6 months) or any major visual, hearing, cognitive or psychiatric conditions precluding consent were excluded. We performed a comprehensive evaluation including a medical evaluation and record review, a directed interview and a self-reported survey on the patient's physical, psychosocial and behavioral functioning using standardized instruments. Descriptive statistics and conditional logistic regressions were used as appropriate. 244 out of 300 eligible survivors (81% response rate) participated (median 8.4 years post HCT; IQR 7.9; range 2.3-24.4). The most prevalent issues noted were graft versus host disease (46.7%), impaired kidney function (63.9%), the presence of a metabolic syndrome (33.6%), medication non-adherence (for immunosuppressive medication: 60.4% implementation issues, 7.5% non-persistence issues; for other medication: 53.8% omission issues), low physical activity (54.5%) and inappropriate UV exposure (44.7%). Compared to the general population, survivors were significantly more likely to report a sub-optimal overall perceived health status (82.0% versus 52.1% respectively, OR 4.58 (3.08-6.80), p These findings point towards the complex care needs of HCT survivors and call for the implementation of chronic care models for follow-up care. We currently are planning an eHealth powered model of care intervention to address these issues.

Associations between Physical Activity and Comorbidities in People with COPD Residing in Spain: A Cross-Sectional Analysis.

There is a high prevalence of comorbidities among patients with chronic obstructive pulmonary disease (COPD). Comorbidities are likely common in patients with any COPD degree and are associated with increased mortality. The aim of this study was to determine the prevalence of thirty-one different COPD comorbidities and to evaluate the association between physical activity (PA) levels in people with COPD residing in Spain. Cross-sectional data from the Spanish National Health Survey 2017 were analysed. A total of 601 adults (52.2% females) with COPD aged 15 to 69 participated in this study. PA (exposure) was measured with the International Physical Activity Questionnaire (IPAQ) short form and comorbidities (outcomes) were self-reported in response to the question “Have you ever been diagnosed with…?” Multivariable logistic regression, in three different models, was used to assess this association. Results showed a high prevalence of comorbidities (94%), these being chronic lumbar back pain (38.9%), chronic allergy (34.8%), arthrosis (34.1%), chronic cervical back pain (33.3%), asthma (32.9%) and hypertension (32.8%) the most prevalent. Low PA level was significantly associated with urinary incontinence (2.115[1.213–3.689]), chronic constipation (1.970[1.119–3.459]), cataracts (1.840[1.074–3.153]), chronic anxiety (1.508[1.002–2.269]) and chronic lumbar back pain (1.489[1.044–2.125]). Therefore, people with COPD should increase their PA levels in order to reduce their risk of comorbidities and increase their quality of life.

Association between serum 25-hydroxyvitamin D levels and myopia in general Korean adults.

Purpose:We performed this study to determine the association between serum 25-hydroxyvitamin D [25(OH) D] level and myopia in adults.Methods:A total of 25,199 subjects aged ≥20 years were included from the National Health and Nutrition Examination Survey 2008–2012. Blood 25(OH)D levels were evaluated from blood samples. Refractive error was measured without cycloplegia. Myopia and high myopia were defined as ≥-0.50 diopters (D) and ≥-6.0 D, respectively. Other covariates such as education, physical activity, and economic status were obtained from interviews.Results:Linear regression analysis showed that as 25(OH) D level increased by 1 ng/mL, myopic refractive error significantly decreased by 0.01 D (P < 0.001) after adjusting for potential confounders including sex, age, height, education level, economic status, physical activity, and sunlight exposure time. The odds ratios for myopia was 0.75 (95% Confidence interval [CI]; 0.67–0.84, P < 0.001) in the highest 25(OH) D quintile compared to the lowest quintile. The odds ratios for high myopia was 0.63 (95% CI; 0.47–0.85, P < 0.001) in the highest 25(OH)D quintile compared to the lowest quintile.Conclusion:Serum 25(OH)D level was inversely associated with myopia in Korean adults.

Children With Metabolically Healthy Obesity: A Review.

Children with “metabolically healthy obesity” (MHO) are a distinct subgroup of youth with obesity, who are less prone to the clustering of cardiometabolic risk factors. Although this phenotype, frequently defined by the absence of metabolic syndrome components or insulin resistance, was first described during the early 1980s, a consensus-based definition of pediatric MHO was introduced only recently, in 2018. The purpose of this review was to concisely summarize current knowledge regarding the MHO phenomenon in youth. The prevalence of MHO in children varies from 3 to 87%, depending on the definition used and the parameters evaluated, as well as the ethnicity and the pubertal status of the sample. The most consistent predictors of MHO in youth include younger age, lower body mass index, lower waist circumference, and lower body fat measurements. Various hypotheses have been proposed to elucidate the underlying factors maintaining the favorable MHO phenotype. While preserved insulin sensitivity and lack of inflammation were previously considered to be the main etiological factors, the most recent findings have implicated adipokine levels, the number of inflammatory immune cells in the adipose tissue, and the reduction of visceral adiposity due to adipose tissue expandability. Physical activity and genetic factors also contribute to the MHO phenotype. Obesity constitutes a continuum-increased risk for cardiometabolic complications, which is less evident in children with MHO. However, some findings have highlighted the emergence of hepatic steatosis, increased carotid intima-media thickness and inflammatory biomarkers in the MHO group compared to peers without obesity. Screening should be directed at those more likely to develop clustering of cardiometabolic risk factors. Lifestyle modifications should include behavioral changes focusing on sleep duration, screen time, diet, physical activity, and tobacco smoke exposure. Weight loss has also been associated with the improvement of insulin sensitivity and inflammation. Further investigative efforts are needed in order to elucidate the mechanisms which protect against the clustering of cardiometabolic risk factors in pediatric obesity, to provide more efficient, targeted treatment approaches for children with obesity, and to identify the protective factors preserving the MHO profile, avoiding the crossover of MHO to the phenotype with metabolically unhealthy obesity.

Appraising causal relationships of dietary, nutritional and physical-activity exposures with overall and aggressive prostate cancer: two-sample Mendelian-randomization study based on 79 148 prostate-cancer cases and 61 106 controls.

Prostate cancer is the second most common male cancer worldwide, but there is substantial geographical variation, suggesting a potential role for modifiable risk factors in prostate carcinogenesis. We identified previously reported prostate cancer risk factors from the World Cancer Research Fund (WCRF)'s systematic appraisal of the global evidence (2018). We assessed whether each identified risk factor was causally associated with risk of overall (79 148 cases and 61 106 controls) or aggressive (15 167 cases and 58 308 controls) prostate cancer using Mendelian randomization (MR) based on genome-wide association-study summary statistics from the PRACTICAL and GAME-ON/ELLIPSE consortia. We assessed evidence for replication in UK Biobank (7844 prostate-cancer cases and 204 001 controls). WCRF identified 57 potential risk factors, of which 22 could be instrumented for MR analyses using single nucleotide polymorphisms. For overall prostate cancer, we identified evidence compatible with causality for the following risk factors (odds ratio [OR] per standard deviation increase; 95% confidence interval): accelerometer-measured physical activity, OR = 0.49 (0.33-0.72; P = 0.0003); serum iron, OR = 0.92 (0.86-0.98; P = 0.007); body mass index (BMI), OR = 0.90 (0.84-0.97; P = 0.003); and monounsaturated fat, OR = 1.11 (1.02-1.20; P = 0.02). Findings in our replication analyses in UK Biobank were compatible with our main analyses (albeit with wide confidence intervals). In MR analysis, height was positively associated with aggressive-prostate-cancer risk: OR = 1.07 (1.01-1.15; P = 0.03). The results for physical activity, serum iron, BMI, monounsaturated fat and height are compatible with causality for prostate cancer. The results suggest that interventions aimed at increasing physical activity may reduce prostate-cancer risk, although interventions to change other risk factors may have negative consequences on other diseases.

Influence of “health” versus “commercial” physical activity message on snacking behavior

PurposeThis study aims to investigate whether the effect of exposure to video communication displaying physical activity (PA) would affect viewers’ snacking behavior depending on the type of message. Specifically, it is expected that food intake would be significantly higher when the message is labeled as a “commercial message” rather than a “health message”.Design/methodology/approachTwo experimental studies are conducted that manipulate the type of message (commercial message vs health message). In Study 1, the participants’ level of involvement (low vs high) is also manipulated. In Study 2, the intensity of the PA displayed in the videos (low vs high) is manipulated, and a control group is included. The main dependent variable is the number of sweets eaten while watching the ad.FindingsResults from both studies show that the influence of a PA exposure on food intake is influenced by the nature of the communication. Participants exposed to the commercial message eat more sweets than those exposed to the health message (ηp2= 0.06). Being exposed to a health message elicits self-regulated eating behaviors with no more sweets eaten than in the control group. In addition, the effect of the type of message is moderated by the intensity of the PA displayed. The difference of sweets consumed depending on the type of message is significant only when the physical intensity displayed is low.Research limitations/implicationsThe present research emphasizes the moderating role of the type of communication on food intake when recipients are exposed to a PA message. Further research must be conducted to enlarge the understanding of the phenomenon considering other critical variables such as inter-individual differences (e.g. body mass index and self-regulation skills), types of food (e.g. healthy vs unhealthy) and other contexts (e.g. watching sports events on television).Practical implicationsThe present findings have implications for marketers, health practitioners, policymakers and consumers. They stress the significance of how the implicit goals of the messages are taken into account within consumers’ information processing and how this can affect subsequent consumption behaviors. PA displayed through a commercial message has the most negative impact on food intake, especially when the intensity of PA is low. PA displayed through a health message shows no impact on food intake, whatever the intensity of the PA. It emphasizes the importance of combining exposure to PA through advertising or sporting events to a message promoting healthy and balanced eating behaviors.Originality/valueThe value of the present research lies in an additional understanding of the complex effect of passive exposure to a PA message on subsequent food consumption. Furthermore, the present study expands research on persuasive communication and has critical implications for public health issues.

Psychosocial and Physiological Health Outcomes of Green Exercise in Children and Adolescents-A Systematic Review.

Both physical activity (PA) and nature exposure are associated with several youth health benefits. However, the health outcomes when being physically active in nature, called Green Exercise (GE), are less clear. Thus, the purpose of this systematic review was to provide an overview of the psychosocial and physiological outcomes of GE in children and adolescents and to outline future GE research directions. The PRISMA statement guided the review. Web of Science, PubMed, ERIC, and APA PsychNET were systematically searched in February 2019, including studies between 2000 and 2019. Fourteen of 1175 identified publications were included, which reported 15 different psychosocial and six different physiological outcomes, with some studies reporting more than one outcome. For 16 outcomes, studies reported either similar or no effects for both GE and comparison groups. For six outcomes, studies reported stronger effects for GE, for three outcomes, studies reported stronger effects in the comparison group. Evidence was rated as weak, using the EPHPP tool. Thus, GE does not have deleterious effects for children and adolescents compared to PA in other settings. GE might be beneficial; however, due to the study’s heterogeneity and quality, it is premature to make definite conclusions. Future research should build the quality of evidence for GE, use more rigorous research designs, and investigate the underlying effects and mechanisms of GE.

Epilepsy and lifestyle behaviors related to bone health.

Adults aged 50years and older with epilepsy face an increased risk of fracture associated both with age and with the use of antiepileptic drugs. Lifestyle behaviors, such as physical activity and calcium and vitamin D intake, have been found to be beneficial to bone health. The aim of this study is to investigate these osteoprotective behaviors in people aged 50years and older with and without epilepsy. In 2010, the Canadian Community Health Survey (CCHS), a cross-sectional survey that collects health-related data nationwide, included a subset of questions related to epilepsy along with the standard items on physical activity, nutrition, and sun exposure. Data on osteoprotective behaviors were extracted and analyzed for adults aged 50years and older. There were no significant findings related to calcium and vitamin D intake as measured by food choices and sun exposure survey items. People with epilepsy participated in physical activity significantly less often and for significantly shorter duration than people without epilepsy. Significantly fewer people with epilepsy reported intending to increase exercise in the next 12months as compared to those without epilepsy. Although adults aged 50years and older with epilepsy face an increased risk of fracture as compared to those without epilepsy, they do not engage in a higher level of osteoprotective behaviors. In fact, adults with epilepsy are less physically active and report less intention to exercise than adults without epilepsy.

Maternal night-eating pattern and glucose tolerance during pregnancy: study protocol for a longitudinal study

IntroductionCoordinating eating schedules with day–night cycles has been shown to improve glucose regulation in adults, but its association with gestational glycaemia is less clear. A better understanding on how eating...

Gender-Specific Risk Factors of Physical Activity-Related Injuries among Middle School Students in Southern China.

This cross-sectional study was carried out to explore the potential risk factors of physical activity-related injuries (PARI) among middle-school students of different genders. Selected by the random cluster sampling method, students aged from 12 to 16 years old in grades 7–8 from six middle schools in Shantou, southern China, were recruited for this investigation in November 2017. Information about socio-demographics, physical activity (PA) exposure time, individual exercise behaviors, risk-taking behaviors, and PARI experiences in the past 12 months was collected. A multivariate logistic regression model was used to explore the risk factors of PARI. A total of 1270 students completed valid questionnaires, with an overall injury incidence of 33.6% (boys: 42.0%; girls: 25.0%), an injury risk of 0.68 injuries/student/year, and an injury rate of 1.43 injuries per 1000 PA exposure hours. For boys, living in a school dormitory, participating in sports teams, exercising on a wet floor, rebellious behavior, and having longer PA exposure time were the risk factors of PARI. For girls, those who were sports team members, whose parents were divorced or separated, and those with longer PA exposure time were more vulnerable to suffer from PARI. In conclusion, PARI was a health problem among middle school students in southern China. Boys and girls differed in PARI occurrence and were affected by different risk factors, which provides a basis for targeted gender-specific intervention programs to reduce the occurrence of PARI among middle-school students.

Factors associated with the prevalence of hypovitaminosis D in pregnant women and their newborns

BackgroundThe finding of hypovitaminosis in pregnancy D has prompted the debate about its supplementation. The objective of the study was to measure the prevalence of hypovitaminosis D in mothers and newborns. MethodsA one-year observational study was conducted including the measuring of vitamin D levels in mothers and in the umbilical cord blood of newborns. An analysis was made of the variables as regards maternal characteristics, delivery and sun exposure. ResultsValues lower than 20ng/mL were found in 64.4% of 745 mothers and 41.3% of 560 newborns, and less than 30ng/mL in 88.7% and 67.1%, respectively. Mean levels were higher in summer–autumn than in winter–spring (21.73 and 13.70ng/mL in mothers and 29.04 and 20.49ng/mL in cord), and higher in the umbilical cord than in the maternal plasma. Multiple pregnancies (OR: 6.29) and non-European origin (OR: 13.09) were risk factors for maternal hypovitaminosis, while maternal supplementation (OR: 0.19), physical activity (OR: 0.57), and sun exposure (OR: 0.46) had a preventive effect. ConclusionsThe high rates of hypovitaminosis support the policy of giving dietary supplements to newborns. The high level of hypovitaminosis found supports the extension of screening and supplementation to all pregnant women, and not only to those with risk factors. The greater difference between mothers and newborns in seasons of low sun exposure can be interpreted as a protective effect.

Physical Activity from Childhood to Adulthood and Cognitive Performance in Midlife

The prevalence of cognitive deficits is increasing worldwide, making risk factor reduction a crucial target on the global public health agenda. Adulthood physical activity (PA) is suggested to protect against old-age cognitive deficits, but the independent role of childhood / youth PA for adulthood cognitive performance is unknown. PURPOSE: We investigated the association between PA from childhood to adulthood and midlife cognitive performance. METHODS: This study is a part of the Cardiovascular Risk in Young Finns Study. From 1980, a population-based cohort of 3,596 children (baseline age 3-18 years) have been followed-up for 31 years in 3-9-year intervals. PA was queried in all study phases. Cumulative PA was determined in childhood (age 6-12 years), adolescence (age 12-18 years), young adulthood (age 18-24 years) and adulthood (age 24-37 years). Cognitive performance was assessed using computerized neuropsychological test in 2011 among 2,026 participants aged 34-49 years. RESULTS: High PA level in childhood (β 0.119, 95% confidence interval (CI) 0.055-0.182, p=0.0002), adolescence (β=0.125 SD, 95% CI 0.063-0.188, p<0.0001), young adulthood (β=0.135 SD, 95% CI 0.063-0.207, p=0.0002) and adulthood (β=0.045 SD, 95% CI 0.013-0.077, p=0.006) was independently associated with better reaction time in midlife. Additionally, an independent association between high PA level in young adulthood (β 0.101, 95% CI 0.001-0.200, p=0.048) and adulthood (β=0.064 SD, 95% CI 0.018-0.110, p=0.006) and better visual processing and sustained attention in midlife was found among men. Associations for other cognitive domains were not found. CONCLUSIONS: Cumulative exposure to PA from childhood to adulthood was found to be associated with better midlife reaction time both in men and women. Furthermore, cumulative PA exposure in young adulthood and adulthood was associated with better visual processing and sustained attention in men. These associations were independent of PA levels in other measured age frames. Therefore, physically active lifestyle should be adopted already in early childhood, and continued into midlife to ensure the plausible benefits of PA on midlife cognitive performance. Concluding, this study provides novel insight into cost-effective and well-timed promotion of cognitive health.